学龄期癫癎患儿SPECT局部脑血流显像和认知功能的关系  

Relationship between SPECT regional cerebral blood flow imaging and cognitive function in schoolage children with epilepsy

作　　者：柳江燕[1] 陈雪红[1] 王正江[1] 胡金贵[1] 冯建中[1] 李益民[1] 鲁秀娟[1] 

机构地区：[1]兰州大学第二医院核医学科,730030

出　　处：《中华核医学杂志》2006年第4期211-213,共3页Chinese Journal of Nuclear Medicine

摘　　要：目的探讨学龄期癫癎患儿 SPECT 局部脑血流(rCBF)显像的特征和认知功能状况及其关系。方法对32例学龄期原发性强直和(或)阵挛发作(GTCS)癫癎患儿进行 SPECT 脑显像及认知功能测试,两者进行相关性分析,并与12例正常儿童进行认知功能比较.结果①32例学龄期原发性癫癎患儿 SPECT 脑显像30例异常,定位率为93.8%,其中29例50个部位 rCBF 减少,rCBF 降低百分比为(21.07±7.09)%;1例2个部位 rCBF 增高,rCBF 增高百分比为(32.22±4.31)%,有92.3%的病灶集中在额、颞、顶、枕叶。②学龄期癫癎患儿言语智商(VIQ)、操作智商(PIQ)和总智商(FIQ)明显低于正常儿童,并存在一定的认知偏异,具有 VIQ>PIQ 倾向:③SPECT 脑显像检出癫癎患儿的病灶个数与认知测试 VIQ、PIQ 和 FIQ 呈负相关,相关系数分别为-0.543(P=0.002)、-0.469(P=0.009)、-0.578(P=.001);病灶范围与 VIQ、PIQ 和 FIQ 呈负相关,相关系数分别为-0.560(P=0.003)、-0.142(P=0.016)、-0.582(P=0.001);病灶区 rCBF 降低和增高百分比与认知测试各智商相关性不显著。结论 SPECT rCBF 显像对儿童原发性癫癎有较高的定位诊断价值;学龄期癫癎患儿存在不同程度的认知障碍,其认知功能减低与病灶的个数和范围呈负相关。Objective To explore the feature of SPECT regional cerebral blood flow （rCBF） imaging, the cognitive functions and the relationship between them in school-age children with primary epilepsy. Methods ^99Tc^m-ethylene cysteinate dimer （ECD） brain imaging was performed on 32 school-age children with primary generalized tonic and （or） clonic seizures（GTCS）. Cognitive functions were also evaluated in all patients and normal children. Relationship between cognitive function and rCBF was compared. Results ①Thirty of 32 （93.8%） patients were abnormal on SPECT imaging. Fifty areas of 29 cases showed decreased rCBF, the percentage of decreased rCBF was （ 21.07 ± 7.09 ） % ; 2 areas of 1 case showed increased rCBF, the percentage of increased rCBF was （32.22 ± 4.31 ） %. 92.3% of the epileptic foci were located in frontal, temporal, parietal and occipital cortexes.② Verbal intelligence quotient （ VIQ）, performance intelligence quotient （PIQ） and full-scale intelligence quotient （FIQ） of children with epilepsy were significantly lower than those of the cofitrols, and there were some cognitive skewnesses in children with epilepsy （ VIQ 〉 PIQ）. ③There was negative correlation between the number of foci and VIQ, PIQ, FIQ, the correlation coefficients were - 0.543 （ P = 0.002 ）, - 0.469 （ P = 0. 009 ）, - 0. 578 （ P = 0. 001 ） ;there was negative correlation between the extent of foci and VIQ, PIQ, FIQ, the correlation coefficients were -0. 560（P =0.003 ）, -0. 142（ P =0.016）, -0. 582（P =0.001 ） ;there was no significant correlation between all the IQ of cognitive test and the percentage of changed rCBF. Conclusions SPECT rCBF imaging may be useful for the localization of epileptic focus. Some of school-age children with epilepsy have impairment of the cognitive function, its magnitude is negative correlated with the number and extent of epileptic foci.

关 键 词：癫痫 体层摄影术 发射型计算机 单光子 局部血流 认知 儿童 

分 类 号：R742.1[医药卫生—神经病学与精神病学]